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Can't take the insomnia any more


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I suffer from pretty severe anxiety--GAD and some social. One of the side-effects (I think) is severe insomnia, though there may be a genetic component to this since my mom suffers from severe insomnia, too.

Anyway, by "severe" I mean most nights I go to bed at 10 (I have to get up at 5 for work) and don't fall asleep until 2:30 or 3:00 a.m. and then have to be up about two hours later.

 

I got tired of mucking around with GP's and went to see a real psychiatrist, who put me on Brintellix, which seemed an odd choice but it's helped reduce my anxiety by about 60% and he says that he may increase the dose if it doesn't get lower than that.

 

The problem is that my sleep is still pretty terrible. It's definitely a bit better--about three nights a week now I'm falling asleep within an hour and sleeping 4-5 hours, which is more sleep than I've had in years, but there's still the other 3-4 nights a week when I'm not sleeping.

 

I was on Ambien for four years about eight years ago, and it worked great but the psychiatrist says that it can cause some memory problems. I also took Diazepam for awhile but that made me groggy all day long and, again, the doctor thinks it causes memory problems.  My dad recommended Benadryl, which knocks him out. I tried it but it felt like I'd had two double lattes--I was running around with all kinds of energy and not sedated AT ALL.

 

I've been going to an anti-anxiety group, doing meditations, breathing exercises, exercise, etc. but I'm still not sleeping and although the Brintellix is activating and keeping me awake, I can feel my body is wearing down from lack of sleep.

 

Anyway, thanks to whoever reads this. If you've got any ideas on how to get some sleep please let me know. I'm starting to feel like my job and to some extent my relationship is in jeopardy because I'm just not at 100% (or even 80%).

 

 

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Standard disclaimer: IANAD.  There are a lot of other things that I've seen commonly prescribed for sleep (non-benzo/z-drug) that haven't been discussed.

 

  1. Low dose trazodone is pretty effective in my experience (50-100mg nightly)
  2. Low dose tryciclic such as amitriptyline or doxepin
  3. Mirtazapine.
  4. Switch from Brintellix to a less stimulating AD.

That's just the tip of the iceberg but please discuss this ongoing issue with your pdoc.  Never make any changes without medical consultation.

Edited by BusuB
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This is an issue I've worked on a lot with my pdoc, because I was having pretty similar difficulties getting to sleep.

 

I take my Zoloft in the morning because it is activating for me, and I can't sleep if I take it at night.

 

I don't use caffeine after 12 pm. 

 

Benadryl can be helpful for sleep, no joke.

 

I've taken Trazodone and it made me so stuffed up that I couldn't breathe, so I didn't continue with it, but it can be very helpful to people who don't have that particular side effect.

 

There are some kinds of herbal teas that can help, like those with hibiscus, passionflower, and/or valerian.

 

I tried Vistaril for a bit.  It didn't help me sleep, but it does help some people.  It's an antihistamine like Benadryl, but stronger and slightly different in chemical composition.

 

Saphris is technically an atypical antipsychotic, but there are some studies that suggest that AAPs can help with OCD, and it makes you drowsy, so that is why I tried it.  It did help with sleep, but didn't do anything for my OCD, and it's very expensive and tastes bad, so that is why I didn't continue with it. [Edited to add: it also made me constipated, although that improved over time.] Still, it's something to be aware of.  The good thing about Saphris is that it helped me develop better sleep hygiene.  I had a bad habit of staying mentally alert playing video games too late at night.  When I was taking the Saphris, I got into the practice of slowing down and toning down my activity for the night starting at about 9:30, and then getting to bed consistently on time.  Reducing stimulation for an hour or so before bed made it easier for my brain to shut off after I got there.  I still do this, even though I don't take Saphris anymore.

 

Now, I try sleeping normally, without extra meds, as much as I can.  If I can't, I take 15 mg of Restoril about 30 minutes before I want to go to bed.  It's pretty easy on the system, and benzos are less addicting if you only take them sporadically instead of every day.  I can't say that I sleep perfectly, but it's better than it was, and it's good enough that I can function pretty well.

 

Good luck and sweet dreams.

Edited by revolution724
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I get this too. Not quite as severely as you, but even when I sleep, it's generally an unrestful kind of doze rather than actual sleep. I take low dose sinequan (doxepin, tricyclic anti dep). 10mg is generally enough to help. It doesn't really help me get to sleep but once I am asleep it keeps me asleep, although it is a bit of a struggle to get up in the mornings.

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Thanks for the tips. I'm going to bring some of these up to my doctor next time I see him. I think this doctor is generally against the benzos and prescription sleep meds. As I said in the original post, he said they can cause memory problems--although continual lack of sleep isn't really helping my memory either, so maybe lesser of two evils? 

I really hesitate to switch Brintellix for something else because a) it's really worked VERY well for my anxiety and b) I had the insomnia before I started taking it and it's not any worse so I don't think the Brintellix is doing anything for it one way or the other.

As for Unisom, there are two different ones. One is diphenhydramine, which is just Benadryl, which does squat for me. Turns out the sleep tabs are doxylamine, which did work for me a bit better but still not great.

 

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